Drug Rush: The Farmacia Boom

Miguel says the most asked for drugs in his store, in rough order, are first, Retin-A, the acne medicine now widely used as a wrinkle remover, which sells for about $8 a tube. Then, Ventolin, for asthma, and Viagra, the famous impotency medicine. Fourth is Nicorette gum — “No prescription needed and it’s a lot cheaper here than on the other side.” And the fifth is Xenical, the weight-loss drug.

A redheaded American, about 30, walks into Payless. His obviously abashed girlfriend trails along, attempting to maintain a discreet distance. “How much for Viagra?” asks the American, not modulating his voice. Miguel quotes a price of $13 for one tablet of 100 milligrams. The gringo replies that another store offered it for $10. “Then,” Miguel says, “that’s where you should probably get it.” The American, somewhat belligerently, says that’s where he’s headed.

Miguel sees a lot of younger men buying Viagra. “Everyone wants to try Viagra. Everyone wants to know what it feels like. And it doesn’t matter if you’re only 20. It works.”

American-developed drugs still being tested for approval are often available in Mexico. “It’s because Salubridad [the Mexican department of health] goes by European studies of a drug, and there the approval is usually faster than in the U.S.”

Like most of the pharmacies in Viva Tijuana, Payless does not sell psychotropics, drugs such as Valium and Prozac. These mood-altering medicines are “controlled” in Mexico and usually available only at older, more established stores, whose license requires that a pharmaceutical chemist oversee the sales, although he does not have to be on the premises.

According to Miguel, recently issued licenses to sell controlled drugs require that a chemist or doctor be at the store. Even if a pharmacy is owned by a doctor, and there are several such at Viva Tijuana, the physician must be present when the controlled drug is sold.

Addicts and recreational drug users, he says, come down “all the time,” seeking tranquilizers like Valium or heavy painkillers like Vicodin, which is not produced in Mexico nor sold in the pharmacies. (Nor is the popular American pain medicine hydrocodone.) “Mexico isn’t a good place to get painkillers. Most Mexicans don’t use them. But they will go to a pharmacy a lot for influenza medicine or antibiotics for colds.” He chuckles, adding, “Mexicans get a lot of colds.” Milder anti-pain medications, such as Darvon or Tylenol with codeine, are available at the pharmacies.

In Mexico, Miguel explains, drugs are grouped into six classifications, or schedules. Schedule 1 consists of hospital-use drugs, such as morphine; these are not available in any pharmacy. Schedule 2 comprises drugs that have high potential to become habit-forming, such as Valium. The third category are painkillers, such as Darvon, and medications that have a lower potential to be addictive or that may become addictive when combined with other drugs. Schedule 4 includes Retin-A, antibiotics, diabetes, and ulcer and hypertension drugs. Schedule 5 includes milder medicines, such as prescription-strength Motrin. The sixth schedule is over-the-counter items such as Tums or Maalox.

Payless sells mostly from Schedule 4. According to Miguel, Salubridad technically requires that purchasers of Schedule 4 drugs show a doctor’s prescription, but the store is not required to record it. “To me, that’s kind of stupid, because anyone can grab a prescription from another person and show it when they go to buy. But even so, anybody [in fact] can just go into any drugstore and buy it without a prescription. They go in and say, ‘Hey, give me that antibiotic, I have a bad cold and I need it.’ Everybody in Mexico does that. It’s been that way for years and years.”

Avenida Revolución is bloated with tourist-oriented drugstores, and the streets that finger off hold many more. Pasted on pharmacy windows or on sandwich signs in doorways are prices of popular drugs and promises of deep discounts. ZANTAC $14.25 — IBUPROFEN $7.95 — WE HAVE THE NEW DIET PILL — PRESCRIPTIONS REFILLED HERE — BEST PRICES GUARANTEED — FABULOUS PRICES. Inside, though, they all seem cloned: solicitous young clerks whose white or light blue smocks impart an air of professionalism, mirrors that create illusions of space, and wraparound shelves that display shiny white boxes with lettering in green, yellow, gray, and purple. Some stores post notices outside advertising Viagra. To satisfy health authorities that they are complying with regulations, the signs state the drug is sold “with prescription only.” Gringos are not likely to be discouraged by this since the signs are written in Spanish.

Americans bringing pharmacy drugs back from Tijuana are legally required to have a prescription from a Mexican doctor. One from an American physician won’t do, since a drug that is approved and available in the United States may not be brought into the country. The rules are set by the Food and Drug Administration and enforced by U.S. Customs. There appears to be a mile-wide breach in the regulations, though, because importing a drug is permitted, says Laura Bradbard, a spokeswoman for the Food and Drug Administration, if “you get sick in, say, Mexico, and get a prescription from a Mexican doctor and you need to continue to take the drug. You would have to have bought the drug in a Mexican pharmacy. That’s OK. We just don’t want people to go over and get a lot of boxes of something and then sell these to someone else.” And if a person brings a pharmacy drug over without a prescription? “As it’s written,” she states, “it’s not allowed. But because there’s more than one agency involved [her agency and Customs], I’m sure there is discretionary room, if it’s just a few boxes someone is bringing in to treat themselves.”

However, a spokesman for Customs at the San Ysidro crossing says that there are daily seizures of pharmaceuticals, small quantities, being brought in illegally by individuals for personal use.

Drugs can be brought across the border legally if they are unavailable in the United States. The purchaser must affirm in writing that they are for personal use and must furnish the name and address of the American doctor who is providing treatment. Only a three-month supply is permitted. An exception to the above requirements is if the drug is a continuation of a medical treatment begun in another country. “We don’t want to prevent someone from trying a treatment they feel they need, if it’s not available here,” says Bradbard.